以THP为主的联合化疗方案治疗多发性骨髓瘤及非霍奇金淋巴瘤103例临床分析  

Clinical analysis of combination chemotherapy mainly with pirarubicin in 103 patients of multiple myeloma and non-hodgkin lymphoma

作　　者：韩红[1] 张克俭[2] 左学兰[2] 曾宪昌[2] 陈飞[2] 

机构地区：[1]华中科技大学同济医学院附属梨园医院血液科,武汉430077 [2]武汉大学中南医院血液科

出　　处：《临床血液学杂志》2008年第6期593-596,共4页Journal of Clinical Hematology

摘　　要：目的:分析以吡柔比星(THP)为主的联合化疗方案对不同临床阶段的多发性骨髓瘤(MM)及非霍奇金淋巴瘤(NHL)的疗效及不良反应。方法:回顾性分析MM及NHL患者共103例。分为初发组、复发组和强化组。其中36例MM患者,采用VTD(THP联合长春地辛及地塞米松)方案化疗,共184个疗程。疗效评定参照欧洲血液和骨髓移植小组制定的MM疗效判断标准。采用CTOP方案(THP联合环磷酰氨、长春地辛及地塞米松)治疗了67例NHL患者,共化疗162个疗程。疗效评定采用WHO制定的实体瘤通用疗效评定标准。分别观察完全缓解(CR)率、部分缓解(PR)率、有效(RR即CR+PR)率、微小反应(MR)率、无改变(NC)率、疾病进展(PD)率等。毒性评价依据WHO抗癌药物毒性反应标准评定分0～Ⅳ级。结果:以THP为主的联合化疗方案治疗MM的CR、PR、MR、NC、PD率初发组分别为32,44,12,8,4,总的反应率为88,有效率76。复发组总的反应率73.9,有效率为65.2。组间比较差异无统计学意义(P>0.01)。NHL的有效率初发组为80.8,复发组为64.3,初发组高于复发组,但2组比较差异无统计学意义(P>0.05)。不良反应方面,与以阿霉素(ADM)为主的联合化疗方案比较Ⅲ及Ⅳ骨髓抑制降低,心脏毒性及脱发等不良反应减低。结论:以THP为主的联合化疗方案对MM及NHL无论是初发、复发还是巩固均为疗效较好、毒性较低的治疗方案。Objective： To analyze the clinical effects, toxicity and side-effects of the combination chemotherapy mainly with pirarubicin （THP） in the patients of multiple myeloma （MM） and non- Hodgkin lymphoma （NHL）. Method： 103 patients of MM and NHL were retrospectively analyzed. They were divided into three groups, as well as primary, relapsing and consolidating group, respectively. 36 MM patients were treated with VTD regimen （pirarubicin combined with vindesine and dexamethason）, the total courses were 184. The curative effects were assessed according to the criterion of the european haematol and bone marrow transplantation group. 67 NHL patients were treated with CTOP regimen （pirarucincin combined with CTX, vindesine and dexamethason） ,the total courses were 162. The curative effects were assessed according to universal criterion of solid tumor established by WHO in 1981. The complete response（CR）, partial response（PR）, minimal response（MR）, no change （NC） and progressive disease（PD） rates were observed. The side-effects were assessed with the WHO criterion of toxicity response to anti-cancer drugs, and divided into 0- Ⅳ grade. Results： CR,PR, MR, NC and PD rates of primary MM patients were 32%, 44%, 12%, 8% and 4%, respectively. Total response rate was 88% and efficient rate was 76 %. Total response of the relapsing group of MM was 73.9 % and efficient rate was 65.2 %. The difference between two groups was not significant （ P 〉0.01）. The efficient rate in the primary NHL group was 80.8 %, while 64.3% in the relapsing group. It was greater in the primary group than in the relapsing group, but the difference was not significant （ P 〉0.05）. Compared with the combination chemotherapy mainly with ADM, and Ⅳ bone marrow suppression decreased. The toxicity on heart and alopecie also decreased. Conclusion： The combination chemotherapy mainly with THP was of more effects, and less side-effects for MM and NHL patients in the primary, replasing and consolidating s

关 键 词：THP 多发性骨髓瘤 非霍奇金淋巴瘤 回顾性 临床分析 

分 类 号：R733.3[医药卫生—肿瘤]